In this pilot study, we did not observe a statistically significant difference in changes in respiratory rate among patients with acute respiratory failure (ARF) due to acute heart failure (AHF) and managed with high-flow oxygen or noninvasive ventilation (NIV). However, the point estimate and its large confidence interval may suggest a benefit of high-flow oxygen.

The primary outcome was change in respiratory rate within the first hour of treatment and was analyzed with a linear mixed model.

Secondary outcomes included changes in pulse oximetry, heart rate, blood pressure, blood gas samples, comfort, treatment failure and mortality.

Among the 145 eligible patients in the three participating centers, 60 patients were included in the analysis [median age 86 (interquartile range (IQR), 90; 92) years].

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